Endocrine Abstracts

Aims: Testosterone treatment is controversial as long-term outcome data are not available; however prescriptions for testosterone are becoming more common.

We looked at the symptoms on presentation, indications for testosterone replacement, forms of testosterone replacement, and adherence to present guidelines for monitoring.

Methods: Data was collected from case notes of 47 patients on testosterone replacement attending endocrine clinics in a district general hospital.

Results: Median age was 57 years (range: 20–86).

The cause of hypogonadism was due to Klinefelter’s syndrome in 6 patients (12.8%), pituitary disease in 12 (25.5%) and testicular disease in 3 patients (6.4%). In a further 15 patients, Hypogonadotrophic hypogonadism was due to genetic causes (8/17%) and chronic systemic illness (7/15%) 46.8% were on testosterone implants, 40% on IM injections and 8.5% on dermal preparations.

At baseline, all patients had low libido, most had erectile dysfunction (91%), 17% had reduction in facial hair, 23% were infertile and 13% had gynaecomastia.

At the onset of treatment, no patient had a rectal examination, 25% (aged >40) had PSA checked. 21% had PSA checked after 1 year on treatment.

Seventy five percent had full blood count at baseline, 68% at 6 months and 55% at 1 year. Sixty percent had Lipids checked at baseline, 50% at 6months, and 35% at 12 months.

Conclusion: Our audit has identified shortfalls in compliance with the guidelines recommended by the American Association of Clinical Endocrinologists. Guidelines from the UK are required and may result in higher rates of appropriate monitoring of therapy.